Provider Demographics
NPI:1750823738
Name:QUINN, CHEYANNE R (FNP - C)
Entity Type:Individual
Prefix:
First Name:CHEYANNE
Middle Name:R
Last Name:QUINN
Suffix:
Gender:F
Credentials:FNP - C
Other - Prefix:
Other - First Name:CHEYANNE
Other - Middle Name:
Other - Last Name:QUINN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:1427 W. RIO GRANDE STREET
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80905
Mailing Address - Country:US
Mailing Address - Phone:719-385-3376
Mailing Address - Fax:719-385-3394
Practice Address - Street 1:1427 W. RIO GRANDE STREET
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80905
Practice Address - Country:US
Practice Address - Phone:719-385-3376
Practice Address - Fax:719-385-3394
Is Sole Proprietor?:No
Enumeration Date:2016-11-08
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0992732363LF0000X
COAPN.0992732363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
COAPN.0992732OtherCOLORADO MEDICAL LICENSE